Published Date: 2013-09-06 23:12:03
Subject: PRO/AH/EDR> MERS-CoV - Eastern Mediterranean (67): Saudi Arabia, WHO
Archive Number: 20130906.1928088
MERS-COV - EASTERN MEDITERRANEAN (67): SAUDI ARABIA, WHO
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A ProMED-mail post
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International Society for Infectious Diseases
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In this update:
[1] Saudi Arabia, new cases, deaths - MOH
[2] Global update - WHO
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[1] Saudi Arabia, new cases, deaths - MOH
Date: Fri 6 Sep 2013
From: Ziad M. Memish, M.D. <zmemish@yahoo.com> [edited]
As
an update on cases of MERS-COV in KSA [Kingdom of Saudi Arabia], the
MOH [Ministry of Health] released the report on 4 new cases yesterday [5
Sep 2013]:
- A 41-year-old female health care worker from Riyadh
with no comorbidities with onset of symptoms on [15 Aug 2013] with
cough and fever. Developed severe pneumonia requiring intubation and
ventilation in critical care unit. There was no history of contacts with
animals or a positive case. Patient condition deteriorated and she
passed away. Investigation of source is still ongoing.
- A
30-year-old Saudi male health care worker from Riyadh who is a contact
of a positive case, and who developed severe pneumonia and intubated [4
Sep 2013]. The patient is currently in critical condition.
- A
79-year-old Saudi female from Hafr Albatin province, a contact of a
positive case from [21 Aug 2013]. Presented with respiratory symptoms
and her condition deteriorated and passed away [2 Sep 2013].
- A
47-year-old Saudi male from Hafr Albatin province, a contact of a
positive case, with onset of symptoms [23 Aug 2013]. Patient condition
deteriorated, requiring critical care, and he is still under treatment
in critical condition.
Detailed investigation of all cases is ongoing.
--
Ziad A Memish, MD, FRCP(Can), FRCP(Edin), FRCP(Lond), FACP
Deputy Minister for Public Health
Director WHO Collaborating Center for Mass Gathering Medicine
Ministry of Health
Professor, College of Medicine
Alfaisal University
Riyadh 11176
Kingdom of Saudi Arabia
<zmemish@yahoo.com>
******
[2] Global update - WHO
Date: Fri 6 Sep 2013
Source: WHO Global Alert and Response [edited]
http://www.who.int/csr/don/don_updates/en/index.html
Middle East respiratory syndrome coronavirus (MERS-CoV) - update 6 Sep 2013
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[4
Sep 2013] - WHO has been informed of an additional 2
laboratory-confirmed cases of infection with Middle East respiratory
syndrome coronavirus (MERS-CoV).
The 1st case was notified by the
Ministry of Health in Tunisia. The patient was a 66-year-old man who
became ill on 1 May 2013 and died on 10 May 2013. The patient was
earlier announced as a probable case while his daughter and son were
laboratory-confirmed with MERS-CoV (DON [disease outbreak news]
published on 22 May 2013). Laboratory confirmation on the case was
recently conducted by the US Centers for Disease Control and Prevention.
The
2nd case was notified by the Ministry of Health in Qatar. The patient
was a 56-year-old woman with underlying medical conditions who became
ill on [18 Aug 2013] and died on [31 Aug 2013]. Laboratory confirmation
was recently conducted by Public Health England, UK.
Globally,
from September 2012 to date, WHO has been informed of a total of 110
laboratory-confirmed cases of infection with MERS-CoV, including 52
deaths.
Based on the current situation and available information,
WHO encourages all Member States to continue their surveillance for
severe acute respiratory infections (SARI) and to carefully review any
unusual patterns.
Health care providers are advised to maintain
vigilance. Recent travellers returning from the Middle East who develop
SARI should be tested for MERS-CoV as advised in the current
surveillance recommendations.
Specimens from patients' lower
respiratory tracts should be obtained for diagnosis where possible.
Clinicians are reminded that MERS-CoV infection should be considered
even with atypical signs and symptoms, such as diarrhoea, in patients
who are immunocompromised.
Health care facilities are reminded of
the importance of systematic implementation of infection prevention and
control (IPC). Health care facilities that provide care for patients
suspected or confirmed with MERS-CoV infection should take appropriate
measures to decrease the risk of transmission of the virus to other
patients, health care workers and visitors.
All Member States are
reminded to promptly assess and notify WHO of any new case of infection
with MERS-CoV, along with information about potential exposures that
may have resulted in infection and a description of the clinical course.
Investigation into the source of exposure should promptly be initiated
to identify the mode of exposure, so that further transmission of the
virus can be prevented.
WHO does not advise special screening at
points of entry with regard to this event, nor does it currently
recommend the application of any travel or trade restrictions.
WHO
has convened an Emergency Committee under the International Health
Regulations (IHR) to advise the Director-General on the status of the
current situation. The Emergency Committee, which comprises
international experts from all WHO Regions, unanimously advised that,
with the information now available, and using a risk-assessment
approach, the conditions for a Public Health Emergency of International
Concern (PHEIC) have not at present been met.
--
Communicated by:
ProMED-mail Rapporteur Marianne Hopp
[With
the inclusion of the 5 newly confirmed cases of MERS-CoV infection,
including 2 deaths in Saudi Arabia, and the one retrospectively
confirmed fatal MERS-CoV infection in Tunisia, the new global total of
laboratory-confirmed cases of MERS-CoV infection will be 116, including
55 deaths. The 4 newly confirmed cases in Saudi Arabia are a bit
disconcerting, as all 4 have had serious disease (including 2 deaths and
2 currently in critical condition), and none of the 4 are reported to
have co-morbidities, a finding that predisposed to more serious disease.
We await further information on investigations surrounding these cases,
including information on the virus(es) identified in these cases.
As
a reminder, the retrospectively confirmed case in Tunisia had a history
of travel to Saudi Arabia and Qatar prior to the onset of illness and
had been considered a "probable case" (while the original laboratory
testing was negative for the MERS-CoV, 2 close contacts of him did test
positive for the MERS-CoV; see MERS-CoV - Eastern Mediterranean (05):
Tunisia ex Saudi Arabia/Qatar, fatal, RFI 20130520.1725864).
For a map of the Middle East, see http://healthmap.org/r/1HAJ. - Mod.MPP]
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